Moguća povezanost gestacijskog dijabetesa s upalom

The aim of this study was to investigate whether gestational diabetes mellitus (GDM) is associated with inflammation by comparing serum levels of human chitinase-3-like protein 1 (YKL-40), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). This case control study included 29 pregnant women with GDM and 29 pregnant women with normal glucose tolerance matched for age (±2 years) and pre-pregnancy body mass index (±2 kg/m2). The YKL-40/CHI3L1 levels were measured, and NLR and PLR investigated. There were no statistically significant differences in maternal age, gestational age, gravidity and parity. Higher YKL-40 levels were recorded in pregnant women with GDM compared to control subjects (203 (65-300) ng/mL vs. 159.2 (14-290) ng/mL, p=0.007). NLR and PLR were significantly higher in GDM compared with control group. In conclusion, GDM is associated with high levels of YKL-40, NLR and PLR, which indicate inflammatory status.Cilj ovoga istraživanja bio je procijeniti je li gestacijski dijabetes melitus (GDM) udružen s upalom i to usporedbom serumskih razina humanog hitinazi-3-sličnog proteina 1 (YKL-40) te omjera neutrofila/limfocita (NLR) i omjera trombocita/limfocita (PLR). U ovo istraživanje parova bilo je uključeno 29 trudnica s GDM i 29 trudnica s normalnom tolerancijom glukoze. Dob (± 2 godine) i indeks tjelesne mase prije trudnoće bili su podjednaki u obje skupine. Mjerene su razine humanog hitinazi-3-sličnog proteina 1 (YKL-40/CHI3L1) te ispitani omjeri NLR i PLR. Nije bilo statistički značajnih razlika u dobi, gestacijskoj dobi i gravidnosti. Zabilježene su više razine YKL-40 u trudnica s GDM u usporedbi s kontrolnim trudnicama (203 (65-300) ng/mL prema 159,2 (14-290) ng/mL, p=0,007). NLR i PLR bili su značajno viši u skupini s GDM nego u kontrolnoj skupini. U zaključku, GDM je udružen s visokim razinama YKL-40, NLR i PLR koji ukazuju na upalno stanje

Maternal serum amyloid A levels in pregnancies complicated with preterm prelabour rupture of membranes

Objective: The aim of the study was to investigate a possible association between maternal serum amyloid A levels (SAA) and maternal and fetal parameters in pregnancies complicated with preterm prelabor rupture of membranes (PPROM). Material and methods: A total of 88 pregnant women (PPROM group, n=44 and control group, n=44) were included into this prospective case control study. Serum blood samples for SAA were obtained from both groups within 1h since the rupture of the membranes and before administration of any medicine. The samples were kept frozen at -70°C until the analysis. The recorded risk factors were: age, gravidity, parity, delivery mode, gender, fetal birth weight, APGAR scores, white blood cell count, microCRP, neutrophil/lymphocyte ratio (NLR), and maternal serum SAA levels. Results: Demographic characteristics showed no statistically significant differences between the groups (p>0.05). The mode of delivery mode was cesarean section: 41% and 43.2% in the study and the control group, respectively, and this difference was statistically significant between the groups (

Predictive Utility of Systemic Immune Inflammation Index (SII) in Identifying Endometrial Carcinoma in Premalignant Endometrial Lesions

INTRODUCTION: It is important to detect endometrial cancer (EC) in endometrial intraepithelial neoplasia (EIN) patients. It was aimed to determine the role of systemic immune inflammation index (SII) in predicting concurrent EC in women with EIN. METHODS: In this retrospective study, 429 women with EIN divided into three groups according to final histopathologic results: benign(n=151), EIN(n=152), and EC(n=126). Demographic and clinical data, pathologic and laboratory result were collected. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII index were calculated and compared among groups. RESULTS: The SII, PLR and NLR values of benign, EIN and EC groups were compared and all values of EC group were the highest. The ROC analysis showed that although all markers had statistical significance, the AUC of SII was the highest. The SII score>0.67 (95%CI: 7.17-37.3) had a 16.35-fold, preoperative platelet count > 287 (95%CI: 1.91-6.2) had a 3.45-fold and age >49 years (95%CI: 1.97-5.92) had 3.42-fold increased risk for EC. DISCUSSION AND CONCLUSION: Although age and preoperative platelet count were found independent risk factors, SII was the strongest predictor for EC in women with EIN. SII can be used as a predictive marker for identifying concurrent EC or having risk for developing EC in women with EIN

Evaluation of mean platelet volume / platelet count ratio in hyperemesis gravidarum

Objectives: To investigate whether serum levels of inflammatory markers including high sensitive C-reactive protein (hs-CRP) and mean platelet volume (MPV) to platelet count ratio (MPR) were altered in patients with hyperemesis gravidarum (HEG) compared to asymptomatic pregnant women. Methods: Ninety pregnant women, 46 with HEG and the other 44 with healthy uncomplicated pregnancies were included the study. MPR was calculated as the MPV value to the platelet count obtained from the same blood sample. The clinical information and the laboratory results of the hematologic and biochemical parameters and hs-CRP levels of each participant were recorded. Results: Platelet counts were didnt differ between the groups. MPV, MPR and hs-CRP values were significantly higher in HEG group than in the control (p=0.01, p=0.05 and p=0.03, respectively). Conclusions: The etiopathogenesis of HEG is still obscure and its likely multi-factorial. Although we didnt demonstrate the statistically significant differences in terms of platelet counts between the groups we find elevated levels of MPV, MPR and hs-CRP which conclude inflammatory basis of the disease. [Med-Science 2019; 8(4.000): 866-9

Retrospective Analysis Of Gestational Trophoblastic Neoplasia: Single Center Experience

This study aims to analyze the clinicopathologic characteristics and treatment outcomes of our patients with gestational trophoblastic neoplasia (GTN) and to present our real-life experience. A total of 32 patients with GTN diagnosed according to the FIGO 2002 criteria followed in Zekai Tahir Burak Women's Health Training and Research Hospital between 2011-2018 were included. Demographic features, treatment outcomes, and survival were analyzed retrospectively. The median follow up time was 32.1 (3.3-76.9) months. Of the 32 patients, 27 (84.4%) were defined as low-risk GTN (risk score = 7) according to the FIGO risk score. Seventeen (62.9%) patients with low-risk GTN achieved complete remission (CR) with single agent MTX. CR rate was 60% (12/20) in patients receiving weekly MTX and 71.4% (5/7) in MTX-FA eight-day regimen (p= 0.590). Of the 9 MTX resistant patients, 8 (88.8%) achieved CR with second-line Actinomycin D (ActD). Three (60%) out of the five high-risk GTN patients acquired CR with first-line EMA-CO (etoposide, MTX, plus ActD alternating with cyclophosphamide and vincristine). In the follow-up period one patient (3.1%) had recurrent disease. By the data cut off date, all of the patients were alive and CR could not be achieved in one (3.1%) patient. All patients with low-risk GM achieved CR with sequential therapies ultimately. Therefore, single agent MTX is a reasonable option in the initial treatment of low-risk GTN. Moreover, Actinomycin D is highly effective in patients with low-risk GTN who are resistant to MTX.WoSScopu

Is there a relationship between serum anti-mullerian hormone levels and abortion rates in patients who received In vitro Fertilisation-embryo transfer cycles?

Background: The studies which investigated the relationship between anti-Mullerian hormone (AMH) level and abortion rate have conflicting results. Aims: This retrospective study aimed to evaluate the relationship between AMH levels and abortion in women who achieved pregnancy with in vitro fertilisation (IVF) treatment. Settings and Design: This retrospective study was conducted in the Department of Gynecology and Obstetrics, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, between January 2014 and January 2020. Materials and Methods: Patients below 40 years of age who conceived after IVF-embryo transfer treatment during a 6-year period and had a serum AMH level measurement were included. The patients were divided into three groups according to the serum AMH levels as low AMH (L-AMH, ≤1.6 ng/mL), intermediate AMH (I-AMH, 1.61–5.6 ng/mL) and high AMH (H-AMH, >5.6 ng/mL). The groups were compared in terms of obstetric, treatment cycle characteristics and abortion rates. Statistical Analysis Used: The Mann–Whitney U-test was used in comparison of non-parametric data of two groups; the Kruskal–Wallis test was used to compare the data of more than two groups. When a statistically significant difference was found in the Kruskal–Wallis test result, the groups were compared in pairs using the Mann–Whitney U-test, and the groups that made a statistical difference were determined. The Pearson's Chi-square and Fisher's exact tests were used to compare the independent categorical variables. Results: L-AMH (n = 164), I-AMH (n = 153) and H-AMH (n = 59) groups were similar in terms of obstetric histories and number of cycles applied, with an abortion rate of 23.8%, 19.6% and 16.9%, respectively (P = 0.466). The same analyses were repeated in two subgroups under 34 years of age and above, and no difference was found in terms of miscarriage rates. The number of oocytes retrieved and the number of mature oocytes were higher in H-AMH group compared to intermediate and low groups. Conclusion: No relationship was found between serum AMH level and abortion rate in women who achieved clinical pregnancy with IVF treatment

Levonorgestrel-releasing intrauterine device versus oral progesterone for treatment of simple endometrial hyperplasia without atypia

The aim of this study was to compare the efficacy and effect on the menstrual pattern of the levonorgestrel releasing intrauterine device versus oral progesterone for treatment in patient having simple endometrial hyperplasia (EH) without atypia. Patients who underwent endometrial sampling with abnormal uterine bleeding history and received simple EH without atypia were included in this study between 1 December 2015 and 31 March 2016, retrospectively. Twenty-two patients were treated with the levonorgestrel-releasing intrauterine device (LNG-IUD) and 47 with oral progesterone. Primary outcome measures were regression of hyperplasia after 3 months of therapy. Secondary outcome measures were effect on menstruel pattern during treatment, or rates of hysterectomy and recurrence within a 12 month period. After 3 months of treatment, regression of EH occurred in all of women in LNG-IUD group versus 93% of women in the oral progesterone group (p=0.226). Hb values were increased at the 3th month measurement in both of groups. Endometrial thickness was significantly decreased at the end of the 3th month (p< 0.001). Amenorrhea was more common in the LNG-IUD group (p [Med-Science 2018; 7(1.000): 21-24

Echogenic particles in the amniotic fluid of term low-risk pregnant women: does it have a clinical significance?

In this study, we aimed to analyse the clinical features of the third-trimester pregnant women, with echogenic amniotic fluid and to compare their obstetric and neonatal outcomes with pregnant women with normal amniotic fluid echogenicity. This case-control study was conducted in a tertiary antenatal care centre. A total of 560 term (37–42 weeks of gestation) singleton women; 280 with echogenic particles in amniotic fluid and 280 with clear amniotic fluid, who delivered within 24 h after the ultrasound scan were evaluated. The women in the two groups were similar in terms of age, parity, body mass index, foetal birth weight, and gestational age. More patients in the particulate amnion group had lower Apgar scores (<7) in 1st and 5th minutes than controls (p = .006, p = .031 respectively) however the rate of admission to neonatal intensive care was similar. Vernix stained amniotic fluid was more common in the study group (48.8%, p = .031), the rate of meconium-stained amniotic fluid was similar in the study and control groups (9.6–9.2%, p = .881). The primary caesarean section rate was higher in women with particulate amnion (18.4%, p = .037). Echogenic particles in the amniotic fluid in the third trimester could not be attributed to meconium, however, higher rates of primary caesarean section may require further attention.IMPACT STATEMENT What is already known on this subject? Previous studies showed that high-density intra-amniotic particles were possibly related to vernix caseosa, intra-amniotic bleeding, and meconium. The number of study groups in these studies was also limited. What do the results of this study add? Additional to other previous studies, we found an increased rate of intra-amniotic echogenic particles in male foetuses. What are the implications of these findings for clinical practice and/or further research? The presence of echogenic particles on ultrasound was not related to increased risk for the presence of meconium. Significantly more neonates born to mothers with intra-amniotic echogenic particles tended to have lower Apgar scores (<7), however, this significant difference did not affect the need for NICU admission. The presence of echogenic particles in the amniotic fluid of the third-trimester pregnant women could not be attributed to meconium and adverse perinatal outcomes, however, the higher rates of primary caesarean section may require further attention

Does the anti-Müllerian hormone truly reflect ovarian response in women with endometrioma?

In this study, our aim was to determine which factor is more correlated with the number of oocytes retrieved in patients with endometrioma compared with controls undergoing in vitro fertilisation–intracytoplasmic sperm injection (IVF–ICSI) cycles: antral follicle count (AFC) or anti-Müllerian hormone (AMH). A total of 60 women with endometrioma and a control population of 60 women without endometrioma in the same period were randomly selected underwent the injection IVF–ICSI treatment. No significant differences were found between the groups in terms of age (28.78 ± 3.49 vs. 29.52 ± 2.47, p = .187), body mass index (23.62 ± 2.05 vs. 23.91 ± 2.11, p = .449), duration of infertility [(3 (2–4) vs. 3 (2–3), p = .139)], AMH level (1.52 ± 0.51 vs. 1.32 ± 0.92, p = .133), duration of stimulation [(9 (9–10) vs. 10 (9–10), p = .135)], total gonadotropin dose [(2750 (2262.5–3337.5) vs. 2770 (2680–3562.5), p = .125)], endometrial thickness [(10 (10–11) vs. 10 (9–11), p = .463)], fertilisation rates (67.20 ± 18.04 vs. 62.28 ± 17.13, p = .123), grade I embryo (43.3% vs. 30%, p = .185), clinical pregnancy rates (40% vs. 26.7%, p = .123), and the perinatal outcomes between the groups. The AFC was higher in the controls than in those with endometrioma (9.20 ± 1.80 vs. 6.32 ± 2.04, p < .001). The number of oocytes retrieved was also higher in the controls than in those with endometrioma [(7 (6–8) vs. 4 (4–5.75), p < .001)]. We found that women with endometrioma had a significantly lower number of oocytes retrieved than the controls despite the same AMH levels in both groups. AFC is a better marker of ovarian response than AMH in women with endometrioma undergoing IVF-ICSI.Impact statement What is already known on this subject? Utilising the ovarian reserve is important in the success of ovarian stimulation and in evaluating the success of assisted reproductive technologies. The anti-Müllerian hormone (AMH) level and the antral follicle count (AFC) are widely used in the prediction of ovarian functional reserve and response. However, no perfect marker exists in the evaluation of ovarian reserve and ovarian response. What do the results of this study add? Our study demonstrated that women with endometrioma have a significantly lower number of oocytes retrieved than the controls, despite the same AMH levels in both groups; which strongly suggests that AFC is a better reflection of ovarian response than AMH in women with endometrioma undergoing an in vitro fertilisation–intracytoplasmic sperm injection (IVF-ICSI). What are the implications of these findings for clinical practice and/or further research? This important issue has been reviewed and discussed for years, however, the conclusions are still controversial. Additional research is needed to understand which ovarian reserve test could better predict ovarian response outcome